At the end of August, the Certification Commission on Health Information Technology (CCHIT) and the Drummond Group were named by the Office of the National Coordinator for Health Information Technology (ONC) as the first technology review bodies that have been authorized to test and certify electronic health record (EHR) systems. Since CCHIT got its start in 2004, the commission has certified a couple hundred EHR systems every year. CCHIT’s Chair Karen Bell, M.D., took time out to speak to HCI Associate Editor Jennifer Prestigiacomo about the commission’s dual certification approach and what’s changed with the announcement of the Stage 1 meaningful use final rule.
Healthcare Informatics: How has the certification process changed in light of the release of Stage 1 requirements for meaningful use?
Karen Bell, M.D.: Prior to the release of the certification criteria by the federal government in July, most products that we were certifying were pretty much state-of-the-art. Then in July, the federal government added on a number of criteria. One of them had to do with the ability to calculate a specific set of quality measures, and that had not been something that CMS had required earlier, so it wasn’t in our system.
Secondly, there were a number of requirements in the criteria that were based on standards that hadn’t been developed yet, so there was a need to think through how to address that [issue], because obviously, if there are no standards, then you’re going to end up with a situation where everyone does it differently. There were also some things like figuring out how to [record] smoking information, where there hadn’t been any standardized way of doing that electronically before. So there were a number of these kinds of things that [providers] requested, but none of the EHRs had them in place. In addition to that, because they [the U.S. Department of Health and Human Services] are very focused on assuring that structured data goes into the electronic health record, they have essentially postponed a lot of the requirements and criteria regarding interoperability, which we’ve been certifying for some time. So there are some differences between the two, and that’s why a number of vendors have to really work hard to come up to speed with assuring that they’re going to be certified by the new criteria that the government has put out.
HCI: Do you think with the inclusion of the emergency department (ED) in Stage 1, you’ll see more products have interoperability between their inpatient and ED systems?
Bell: Right now, they’re [ONC] not focusing on emergency department EHRs. They have quality measures that the hospitals are required to report, but they are not focusing on emergency room EHRs. They’re simply focusing on hospitals where the emergency department is already integrated in. I think we will be seeing a lot more need for interoperability as time goes on.
HCI: What are your goals for the Sept. 20 town hall meeting coming up?
Bell: This will be an opportunity to open up and start certifying all the vendors out there who are ready to go. We don’t have a process where we open up and take applications and tell them, ‘Well, we’ll get back to you in a few weeks.’ Once we open and start taking applications, we will be certifying those EHRs in a matter of a very short time period, and then announcing those very quickly.
HCI: How long does it take for CCHIT to certify a product?
Bell: To this point in time, we’ve kept it to a one-day process. There’s a lot of stuff that’s gone into that, and we’ve been lucky to have an opportunity to look at a lot of efficiencies over the course of the last several years.